What is Esophageal Atresia Repair
Esophageal atresia occurs when the upper part of the esophagus is not connected to the lower part. The esophagus is the part of the body that moves food from the mouth to the stomach. With esophageal atresia, the upper part of the esophagus ends in a pouch instead of going to the stomach.
This means that your baby cannot eat or drink. Esophageal atresia is a problem that your baby was born with (congenital defect). It can be fixed with surgery (esophageal atresia repair).
Most children who have esophageal atresia also have another defect that involves an abnormal connection (fistula) between the windpipe (trachea) and the esophagus. This defect is called a tracheoesophageal fistula. Fluids from the esophagus may leak through the fistula into your baby’s lungs and cause breathing problems or a lung infection (pneumonia). Both of these defects are very dangerous for your baby. However, most children who have esophageal atresia repair grow up without medical problems and can participate in the same activities as other children.
Tell a health care provider about:
- Any problems you or family members have had with anesthetic medicines.
- Any medical conditions you or family members have, including blood disorders.
What are the risks?
Generally, this is a safe procedure. However, problems may occur, including:
- Infection.
- Bleeding.
- Leaking of food or liquids from the surgical area.
- Damage to the esophagus or trachea.
- Allergic reactions to medicines.
- Low body temperature (hypothermia).
- Collapsed lung (pneumothorax).
- Scar tissue that blocks swallowing (stenosis).
- Heartburn and spitting up (reflux).
- The fistula developing again after surgery (recurring).
What happens before the procedure?
After your baby is diagnosed, he or she will be taken to the infant (neonatal) intensive care unit (NICU). In the NICU:
- An IV will be inserted into one of your baby’s veins, usually in the chest or the umbilical cord. Your baby will be given antibiotic medicine through the IV to help prevent infection.
- A tube may be placed into your baby’s trachea (endotracheal tube) and connected to a machine that helps your baby to breathe (ventilator).
- A tube will be placed through your baby’s nose or mouth and into the throat (drain tube). This tube will drain fluids that collect during surgery.
What happens during the procedure?
- To
lower your baby’s risk of infection:
- Your baby’s health care team will wash or sanitize their hands.
- Your baby’s skin will be washed with soap.
- Your baby will be given a medicine through the IV to make him or her fall sleep (general anesthetic).
- An incision will be made on the right side of the chest.
- An opening will be made between the ribs, to allow access to the inside of your baby’s right lung.
- If there is a tracheoesophageal fistula, it will be closed so that fluids cannot leak into the trachea or lungs anymore.
- The pouch end of the upper part of the esophagus will be opened.
- The top end of the lower part of the esophagus will be opened.
- The two ends of the esophagus will be connected with stitches (sutures).
- A tube will be passed through the esophagus and into the stomach (stomach tube).
- The chest incision will be closed with stitches (sutures), skin glue, or adhesive strips.
- A bandage (dressing) will be placed over the incision.
The procedure may vary among health care providers and hospitals.
What happens after the procedure?
- Your baby will stay in the NICU in a warm crib (isolette) for a week or longer.
- Your baby will receive fluids, pain medicine, antibiotics, and nutrition through his or her IV.
- Your baby’s stomach tube will be cleared of fluid (suctioned) regularly.
- Your baby may continue to have an endotracheal tube and ventilator for a few days to provide breathing support.
- After
about one week, X-rays will be taken of your baby’s chest and esophagus.
If the X-rays are normal:
- Your baby may start feedings with formula or with pre-pumped (expressed) breast milk.
- After your baby is eating well, the stomach tube and IV will be removed.
Summary
- Esophageal atresia occurs when the upper part of the esophagus is not connected to the lower the lower part. This means that your baby cannot eat or drink.
- Most children who have esophageal atresia also have another defect that involves an abnormal connection (fistula) between the windpipe (trachea) and the esophagus. This defect is called a tracheoesophageal fistula.
- Esophageal atresia can be fixed with surgery (esophageal atresia repair).
- Most children who have a procedure called esophageal atresia repair grow up without medical problems and can participate in the same activities as other children.
- After the procedure, your baby will stay in the NICU in a warm crib (isolette) for a week or longer.
Esophageal Atresia Repair, Care After
This sheet gives you information about how to care for your baby after his or her procedure. Your baby’s health care provider may also give you more specific instructions. If you have problems or questions, contact your baby’s health care provider.
What can I expect after the procedure?
After the procedure, it is common for babies to have:
- Frequent spitting up.
- Coughing.
- Trouble swallowing while feeding.
Follow these instructions at home:
- Bathe and feed your baby as told by your baby’s health care provider. If your baby has trouble feeding or swallowing, you may need to work with a nutrition and feeding therapist.
- Give your baby over-the-counter and prescription medicines only as told by his or her health care provider. Your baby will need to be given an antacid medicine for about 6 months after surgery.
- Follow
instructions from your baby’s health care provider about how to take care
of your baby’s incision. Make sure you:
- Wash your hands with soap and water before you change your baby’s bandage (dressing). If soap and water are not available, use hand sanitizer.
- Change your baby’s dressing as told by your health care provider.
- Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your baby’s health care provider tells you to do that.
- Check
your baby’s incision area every day for signs of infection. Check for:
- Redness, swelling, or pain.
- Fluid or blood.
- Warmth.
- Pus or a bad smell.
Keep all follow-up visits as told by your baby’s health care provider. This is important. Your baby will need to have checkups on a regular basis.
Contact a health care provider if:
- Your
baby has any of these:
- A fever.
- Trouble feeding.
- An ongoing cough.
- Redness, swelling, or pain around the incision area.
- Fluid or blood coming from the incision area.
- Pus or a bad smell coming from the incision area.
- Your baby’s incision area feels warm to the touch.
- Your baby spits up after every feeding.
- Your baby is not gaining weight.
Get help right away if:
- Your baby has a fever, has a cough, and is struggling to breathe.
- Your baby’s lips, fingers, or skin turn blue.
- Your baby vomits for more than 24 hours.
- Your baby seems to be choking.
- Your baby stops breathing for short amounts of time.
- Your baby who is younger than 3 months has a temperature of 100°F (38°C) or higher.
Summary
- It is common for babies to have some trouble swallowing after this procedure.
- Give your baby over-the-counter and prescription medicines only as told by his or her health care provider. Your baby will need to be given an antacid medicine for about 6 months after surgery.
- Get help right away if your baby seems to be choking or has a temperature of 100°F (38°C) or higher.
